The International journal of risk & safety in medicine最新文献

{"title":"Audit of referrals of patients on oral antithrombotic therapy to a hospital oral surgery service for simple tooth extractions.","authors":"Lea Vuletić, Monika Burja Vladić, Ivan Salarić, Ena Zdunić, Berislav Perić","doi":"10.1177/09246479251389205","DOIUrl":"10.1177/09246479251389205","url":null,"abstract":"<p><p>ObjectiveTo assess the proportion of patients referred to a hospital oral surgery department for procedures that could have been managed in primary care.MethodThis cross-sectional audit included 41 outpatients on oral antithrombotic therapy who were referred to the University Hospital Dubrava in Zagreb, Croatia, for simple tooth extraction(s). Information about additional factors that may affect the complexity of the intervention was collected using a questionnaire. Any instructions regarding patients' antithrombotic therapy regimens were also recorded. An oral surgeon evaluated whether each surgical procedure could have been safely performed in primary care.ResultsThe oral surgeon estimated that in 75.6% (31/41) of the cases, the indicated extractions could have been safely managed in primary care, provided the clinician had relevant training and confidence. Instructions to discontinue antithrombotic therapy prior to the procedure were frequently encountered and, in most cases, issued by the patients' dentists.ConclusionThe findings of this study support the need for more comprehensive studies on the quality, appropriateness and underlying reasons for referrals to oral surgery departments. Such research would provide evidence to guide the development and implementation of measures aimed to enhance dentists' clinical skills, self-confidence, and interdisciplinary collaboration, ultimately improving patient care.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"106-113"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient viewpoint: The case for exploring non-seizure alternatives to ECT.","authors":"Christopher James Dubey","doi":"10.1177/09246479251377340","DOIUrl":"10.1177/09246479251377340","url":null,"abstract":"<p><p>This patient commentary addresses the absence of rigorous placebo- or sham-controlled trials for electroconvulsive therapy (ECT) and discusses whether its therapeutic effects are partly attributable to non-seizure components like anesthesia and subthreshold electrical stimulation. It proposes noninferiority trials comparing ECT and non-ictal treatments such as subconvulsive electrotherapies and psychotherapeutic anesthesia to investigate these components and evaluate potential alternatives with lesser adverse effects.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"9-13"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence, clinical science, and clinical practice.","authors":"David Healy","doi":"10.1177/09246479251381514","DOIUrl":"10.1177/09246479251381514","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"14-15"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further studies comparing ECT to potential alternatives may reveal confounding by its non-seizure components.","authors":"Christopher James Dubey","doi":"10.1177/01410768251381771","DOIUrl":"10.1177/01410768251381771","url":null,"abstract":"<p><p>This commentary discusses the lack of rigorous placebo- or sham-controlled trials for electroconvulsive therapy (ECT). Further, it considers the scientific questions of whether the therapeutic effect of ECT is partly due to its non-seizure components, such as anesthesia and subthreshold electrical stimulation. Finally, further trials are suggested to compare ECT to treatments that highly resemble these non-ictal components. Such research could potentially answer these questions and explore the indications for these alternatives, which have less intense adverse effects.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"5-7"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feelings of guilt and circles of support: Community physicians' experiences following adverse events.","authors":"Ariela Popper-Giveon, Yael Keshet, Tamar Adar","doi":"10.1177/09246479251372328","DOIUrl":"10.1177/09246479251372328","url":null,"abstract":"<p><p>BackgroundInvolvement in adverse events negatively impacts physicians and might harm their job performance and lead to emotional stress and burnout. Sources of support are therefore crucial, especially for community physicians who often work alone or in small clinics.ObjectiveTo examine community physicians' feelings following adverse events and to map their various sources of support.MethodsIn-depth interviews were conducted with 20 community physicians, comprising 10 family physicians and 10 other specialists.FindingsInterviewees described painful negative feelings following adverse events. Guilt was mentioned as the dominant emotion, accompanied by self-doubt, anger, frustration, and shame. They described various circles of support, both personal and professional, with whom they share and consult following adverse events: family members, friends, colleagues, clinic staff, risk management units, and other professional authorities. Support was described as most effective when given by those with whom the physicians had both personal and professional relations.ConclusionsFormal support for \"second victim\" community physicians is essential, preferably from those with whom they have both personal and professional relations. Practical recommendations regarding how to better support them following adverse events are offered.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"40-48"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of using a mobile app to improve medication adherence and glycated hemoglobin in type 2 diabetes: A before-after study.","authors":"Fatemeh Bakhtiari, Firozeh Sajedi, Maryam Etminaniesfahani, Maryam Rangchian","doi":"10.1177/09246479251377937","DOIUrl":"10.1177/09246479251377937","url":null,"abstract":"<p><p>BackgroundAlthough medication adherence is an important factor affecting treatment outcomes, many diabetic patients have yet to achieve acceptable adherence.ObjectiveMeasuring the potential of a mobile application to improve medication adherence and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, consuming oral medicines to control diabetes.MethodsThirty cases in the control group received routine services. Thirty patients in the intervention group received a mobile application that provided audio alarms and a cartoon animation showing four gestures at the time of the medicine consumption, with three repeats after 10, 20, and 30 min. The measured outcomes were medication adherence and HbA1c.ResultsThe medication adherence in the intervention group was significantly higher than the control group in all time points after starting the intervention (mean rank of 35.3 vs 25.7 at month 1; 37.0 vs 21.1 at month 2; 37.7 vs 20.5 at month 3, all <i>p</i>-values = 0.00). 0.28% reduction of the HbA1c was obtained for the intervention group (<i>p</i>-value = 0.02).ConclusionsIt is plausible to propose the utilization of the studied application as a means to improve medication adherence in patients with type 2 diabetes. Clinically meaningful reduction of HbA1c was not observed in this study.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"78-86"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of Russian-produced clinical practice guidelines using the RIGHT reporting checklist: The case of direct oral anticoagulants for coronavirus disease 2019.","authors":"Elena A Baybulatova, Mikhail S Chenkurov, Elina A Korovyakova, Sergey K Zyryanov, Dmitry A Sychev, Irina V Poddubnaya, Yaolong Chen, Janne Estill, Liliya E Ziganshina","doi":"10.1177/09246479251375246","DOIUrl":"10.1177/09246479251375246","url":null,"abstract":"<p><p>ObjectiveThe objective of the study was to compare the results of quality assessment of Russian-produced clinical practice guidelines on the use of direct oral anticoagulants in the treatment and prophylaxis of coronavirus disease 2019 using the RIGHT checklist and AGREE II instrument.MethodsWe assessed six relevant clinical practice guidelines published between 2020 and 2023 in Russian databases using the RIGHT checklist. We compared the results of using the RIGHT tool with the results obtained using the AGREE II instrument.ResultsAll six clinical guidelines received high scores in the sections \"Basic information\" (range: 56.2%-70.8%) and \"Background\" (48.4%-74.0%). The lowest results were obtained in the sections on RIGHT: \"Review and quality assurance\" (0%-4.2%) and \"Funding and declaration management of interests\" (14.6%-19.8%).ConclusionThe RIGHT checklist was proven applicable and usable for evaluating Russian-produced clinical practice guidelines. The use of RIGHT reporting tool enriched the depth and breadth of quality assessment to identify more areas that are problematic and to critically appraise details of the problems. More efforts are needed to further improve Russian clinical practice guidelines and their implementation into clinical practice to ensure better patient care and rational use of direct oral anticoagulants.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"49-66"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence: Medical journalism and medical science.","authors":"David Healy, Liliya Eugenevna Ziganshina","doi":"10.1177/09246479251381515","DOIUrl":"10.1177/09246479251381515","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"3-4"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of pheniramine misuse among substance use disorder patients: A narrative review of extent, patterns, and clinical implications.","authors":"Raja Babu Ramawat, Omar Afroz, Rizwana Quraishi, Siddharth Sarkar","doi":"10.1177/09246479251370587","DOIUrl":"10.1177/09246479251370587","url":null,"abstract":"<p><p>BackgroundThere is growing concern about the misuse of Over-the-counter (OTC) medications around the world. Pheniramine is a first-generation antihistamine, which is widely available and is commonly used for allergic conditions. Initially considered to be a safe anti-allergic agent, growing evidence suggests its potential for misuse and dependence. Notably, it is reported that pheniramine is being used to mix other substances such as opioids during injection drug use. However, pheniramine misuse is not adequately studied in existing literature.ObjectiveThis review aims to synthesize the literature on pheniramine misuse, and summarize the published case reports on pheniramine misuse to understand its clinical implications.MethodsA comprehensive literature search was conducted using PubMed, Google Scholar, and MedSearch to identify case reports, epidemiological data, and clinical studies regarding pheniramine misuse. We included articles in English language, published in peer- review journals, and indexed in PubMed. The keywords for the search included 'Pheniramine use', 'misuse' 'abuse', 'dependence', 'harmful use', 'substance use disorder', 'opioid use disorder', and 'injecting drug user'.ResultsPheniramine has misuse potential comparable to Lorazepam. It is often combined with opioids and/or diazepam and used through injection route, commonly in South Asian region. Studies on extent of its use are mainly from South Asia, which report comorbid use of pheniramine ranging from around 15% to 80% in injection drug users. Use of pheniramine is often under-reported by patients. In literature, more than 8 case reports describe the misuse/dependence of pheniramine and associated complications such as seizures, psychosis, and life-threatening toxicity. Easy accessibility might be one of the contributing factors for pheniramine misuse.ConclusionPheniramine misuse is an emerging challenge and clinicians should remain vigilant about its signs, especially in those with substance use and psychiatric comorbidities.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"16-22"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misguided medical insurance and government policies in the opioid epidemic: A chart review and NARX score analysis.","authors":"Leon Margolin, Juscelino F Colares, Sanford Lefkowitz, Richard Ancowitz, Sanford Rosenblum","doi":"10.1177/09246479251360693","DOIUrl":"10.1177/09246479251360693","url":null,"abstract":"<p><p>BackgroundDespite the investment of significant effort and resources, our country remains exposed to an alarming risk of opioid overdoses due to opioid addiction.ObjectiveThis study demonstrates the impact of misguided medical insurance and government policies on the opioid epidemic.MethodsThis is a retrospective chart review study of 142 patients who were denied access to care by insurance companies (CareSource, Molina, Aetna, government regulators, and contractors). The study provides a systematic analysis of the risk stratification of these patients based on the NARX score, prescribed medications, and OARRS report analysis.ResultsPatients who were denied access to care by the major insurance carriers in Ohio, CareSource, Aetna, and Molina had an average high NARX score of 309.8-310.5 range. The review of the prescribing provider lists on Ohio Automated RX Reporting System reports showed that, in most occasions, patients had significant difficulty in finding a qualified pain provider for 3 months or more.ConclusionReview of denied-care patient NARX scores shows, conclusively, that very high-risk patients were affected the most. These misguided medical insurance and government policies have exposed the most vulnerable and high-risk patients to significant risk of mortality and morbidity.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"31-39"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}